COPD Exacerbation PSP Question Verification Form

Contents

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

COPD Flare-ups

Please describe the scope of the PSP

The scope of the COPD Exacerbations PSP is defined as:

The main themes are in relation to diagnosis, prevention, and management of exacerbations incorporating treatment. These can be conceptualised as:

Why did this event happen? What causes exacerbations?

How can we treat exacerbations while they are happening? This includes self-care, additional support e.g. physiotherapy, occupational therapy, psychological support and clinician led support.

What can we do to prevent them from happening in the future, both self-care and multi-disciplinary clinical support?

The PSP has agreed that this PSP cannot cover all elements of COPD. Therefore, it is agreed that the PSP would concentrate on exacerbations in people with COPD. The group recognised the need to include those who may refer to their disease using alternative terms such as emphysema or chronic bronchitis. This will be reflected in the survey when we ask who is completing the survey.

Included in the COPD Exacerbation PSP scope:

Any participant above 18 years of age (adult) We will only consider responses from the UK. Excluded from the COPD Exacerbation PSP scope: Asthma Responses from industry or pharmaceutical companies. The Steering Group is responsible for discussing what implications the scope of the PSP will have for the evidence-checking stage of the process. Resources and expertise will be put in place to do this evidence checking.

Please provide a brief overview of your approach to checking whether the questions were unanswered

  • The finalized summary questions were checked against the available evidence in the literature to determine if they are “true uncertainties” or unanswered questions. The health care professionals in the steering group assisted those who undertook the evidence checking to review the results. When 3 or 2 say its an uncertainty>>>it goes forward as such.
  • When 3 say its answered>>>it will not be taken forward.
  • If 2 say answered and 1 uncertain>>> resolved by email discussion.
  • Voting if there is no agreement between the clinicians.
  • Prioritising identified uncertainties for the next engagement.

Please list the type(s) of evidence you used to verify your questions as unanswered

The evidence used to verify the questions are unanswered were as follows:
Peer-reviewed papers
High quality evidence sources
Guidelines

Where there is Level 1 evidence (recent SR >=2015, or one or more good RCTs) we will stop and that will not be an uncertainty.

Please list the sources that you searched in order to identify that evidence

We searched in National Institute for Health and Care Excellence (NICE) 2019 guidelines, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 guidelines and Cochrane library.

What search terms did you use?

We searched the main key words in the question depending on the type of question in addition to the COPD Exacerbation and type of study, such SR or RCT.

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

We included recent updated references 2015 onwards, English language, human and only those with full text.

Names of individuals who undertook the evidence checking

Health care professionals:

Jaber Alqahtani, Project Coordinator, Respiratory Medicine, University College London
John HURST, Professor of Respiratory Medicine, University College London
Tom WILKINSON, Professor of Respiratory Medicine, University of Southampton
Charlotte BOLTON, Professor of Respiratory Medicine, University of Nottingham
Jennifer QUINT, Reader in Respiratory Epidemiology, Imperial College London
Elizabeth SAPEY, Reader in Respiratory Medicine, University of Birmingham
Mona BAFADHEL, Associate Professor in Respiratory Medicine, University of Oxford
Heidi RIDSDALE, Service Lead and Specialist Physiotherapist, Camden COPD and Home Oxygen Service
Joanne KING, Consultant Respiratory Nurse, Clinical Lead for the Adult Integrated Respiratory team
Steve HOLMES, General Practitioner, Park Medical Practice, Shepton Mallet.

On what date was the question verification process completed?

07/05/2020

Any other relevant information

[None]